HEART Score Calculator
Calculate the HEART score for early risk stratification of chest pain patients in the emergency department.
About this calculator
The HEART score stratifies emergency department chest pain patients by summing five clinical findings -- History, ECG, Age Category, Risk Factors, and Troponin -- each scored 0, 1, or 2 points on an identical scale, so History (the first of the five entered) moves Total Score exactly as much as raising any other single component: taking any one category from its lowest to its highest option raises Total Score by 2, the same swing any of the other four can produce alone. No category is weighted more heavily in the arithmetic than another. The resulting 0-10 Total Score sorts patients into three risk bands originally reported in Backus et al.'s 2013 multicenter validation study: a score of 0-3 (Low Risk) carried a 1.7% six-week risk of a major adverse cardiac event (MACE -- death, myocardial infarction, or revascularization), 4-6 (Moderate Risk) carried 16.6%, and 7-10 (High Risk) carried 50.1%.
Those three numbers are exactly what this calculator returns for each risk category, not an approximation. A low HEART score is one input supporting early discharge with outpatient follow-up, not a standalone decision -- it is meant to be combined with clinical judgment, serial troponins, and the treating clinician's overall gestalt, and it does not replace ECG interpretation or troponin trending on its own.
Medical Disclaimer
This calculator is for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions about your health. Never disregard professional medical advice or delay seeking it because of results from this tool.
Inputs
Results
HEART Score
0/ 10
Risk Category
1(1=Low, 2=Moderate, 3=High)
Figures current as of 2013. Source: Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013;168(3):2153-2158.
How to Use This Calculator
- Score History (0–2), ECG (0–2), Age Category (0–2), Risk Factors (0–2), and Troponin (0–2).
- Review HEART Score — 0–3 is low risk (MACE < 2%), 4–6 is moderate, 7–10 is high risk.
- Low HEART Score supports early discharge with outpatient follow-up.
What each input means
- History
- Clinical suspicion based on history.
- ECG
- ECG findings.
- Age Category
- Patient age category.
- Risk Factors
- Risk factors include HTN, DM, smoking, obesity, family history, hyperlipidemia.
- Troponin
- Troponin level relative to normal limit.
How this is calculated
Worked example, using the default values
- Identify Input Parameters4 parametersHistory = 0, ECG = 0, Age Category = 0, Risk Factors = 0 = 5 input(s) provided
- Calculate HEART ScoreHEART Score0 = 0
- Calculate Risk CategoryRisk Category1 = 1
- Calculate 6-Week MACE Risk6-Week MACE Risk1.7 = 1.7%
Figures and sources
- HEART Score (ED chest pain risk stratification, prospective multicenter validation) (2013) — Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013;168(3):2153-2158.
Engine last updated . Checked against 3 independently-derived tests — how we verify calculators. Built by Paul Gunder, a software engineer, not a licensed financial, medical, or legal professional.
Frequently Asked Questions
Do all five HEART score categories carry the same weight?
Yes. History, ECG, Age Category, Risk Factors, and Troponin are each scored 0, 1, or 2 points and summed directly with no multipliers, so moving any single category from its lowest option to its highest raises the Total Score by exactly 2 points -- the same amount any of the other four categories can move it on its own.
What do the three HEART score risk categories mean?
A Total Score of 0-3 is Low Risk with a 1.7% six-week MACE rate, 4-6 is Moderate Risk at 16.6%, and 7-10 is High Risk at 50.1%. These figures come from Backus et al.'s 2013 prospective multicenter validation of the HEART score in 2,440 chest pain patients, not from this calculator's own estimate.
Can a low HEART score alone clear a patient for discharge?
No. A Low Risk score (0-3) supports considering early discharge with outpatient follow-up, but the HEART score was designed as one input into a broader clinical decision, not a stand-alone rule-out test. It should be combined with serial troponin trends, ECG findings over time, and the treating clinician's overall assessment.
What counts as a risk factor for the Risk Factors category?
The HEART score's Risk Factors category counts traditional cardiovascular risk factors -- hypertension, diabetes, current smoking, obesity, a family history of coronary disease, and hyperlipidemia -- along with any known history of atherosclerotic disease, which alone is enough to score the maximum 2 points regardless of how many other risk factors are present.
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